Han Kyung Seok, Jeong In Gab, Joung Jae Young, Yang Seung Ok, Chung Jinsoo, Seo Ho Kyung, Kwon Kyung Suk, Park Weon Seo, Lee Kang Hyun
Urologic Oncology Clinic, National Cancer Center, Goyang, Korea.
Urol Int. 2008;80(3):264-9. doi: 10.1159/000127338. Epub 2008 May 14.
Frequent mutations or deletions of PTEN (phosphatase and tensin homolog deleted on chromosome 10) are reported in bladder cancer, while there are few studies which evaluated PTEN as a clinical prognostic parameter of superficial bladder cancer. We prospectively evaluated PTEN expression in patients with superficial bladder cancer by immunohistochemical staining and defined the value of PTEN mutations in predicting tumor behavior of superficial bladder cancer.
A total of 190 patients were enrolled in this study. All of the patients underwent transurethral resection of bladder tumor and had superficial tumors. All pathologic materials used in this study were obtained from transurethral resection of bladder tumor. Immunohistochemical stainings were performed. The immunohistochemical staining intensity was judged to be either normal or reduced compared with the PTEN protein expression of positive and negative controls. Disappearance of more than 50% stained cytoplasmic granules was defined as reduced PTEN expression.
The alteration of PTEN expression was significantly different according to tumor stage and grade (p = 0.03, p = 0.048), especially high in carcinoma in situ. However, PTEN expression was not significantly correlated with disease recurrence, progression and recurrence- or progression-free survival.
Reduced PTEN expression relates to aggressiveness of bladder tumors but seems not to have enough specificity for clinical use in the management of superficial bladder cancer.
据报道,膀胱癌中常出现PTEN(第10号染色体缺失的磷酸酶和张力蛋白同源物)突变或缺失,然而,很少有研究将PTEN评估为浅表性膀胱癌的临床预后参数。我们通过免疫组织化学染色前瞻性评估了浅表性膀胱癌患者的PTEN表达,并确定了PTEN突变在预测浅表性膀胱癌肿瘤行为中的价值。
本研究共纳入190例患者。所有患者均接受了膀胱肿瘤经尿道切除术,且肿瘤均为浅表性。本研究中使用的所有病理材料均取自膀胱肿瘤经尿道切除术。进行了免疫组织化学染色。与阳性和阴性对照的PTEN蛋白表达相比,免疫组织化学染色强度被判定为正常或降低。超过50%的染色细胞质颗粒消失被定义为PTEN表达降低。
PTEN表达的改变根据肿瘤分期和分级有显著差异(p = 0.03,p = 0.048),原位癌中尤其高。然而,PTEN表达与疾病复发、进展以及无复发或无进展生存期无显著相关性。
PTEN表达降低与膀胱肿瘤的侵袭性相关,但似乎对浅表性膀胱癌管理中的临床应用没有足够的特异性。